Mediators and cytokines in allergic and viral-triggered rhinitis.

Intermittent allergic rhinitis and common cold constitute frequent conditions and show similar clinical symptoms. The purpose of this study was to investigate the pattern of cytokines in the nasal fluid of patients with acute symptoms caused by allergic and viral rhinitis. Nasal secretions were analyzed by immunosorbent assay techniques using a cytokine panel assay and routine ELISA. Allergic patients had significantly higher levels of eosinophil cationic protein (ECP), interleukin (IL)-5, and tryptase. Significantly elevated concentrations of proinflammatory cytokines (IL-1b, IL-6, IL-7, IL-17, interferon [IFN] gamma, and tumor necrosis factor [TNF]-alpha) as well as chemokines for cellular infiltration (IL-8, monocyte chemoattractant protein 1, and macrophage inflammatory protein 1beta), factors for cellular proliferation (granulocyte colony-stimulating factor [G-CSF] and granulocyte macrophage colony-stimulating factor [GM-CSF]), and elastase were found in viral rhinitis. IL-10 was only detectable in viral rhinitis. IL-4 was significantly higher in patients with viral rhinitis than allergic rhinitis, and IL-5 was significantly elevated in viral rhinitis compared with controls. In viral-triggered rhinitis, we detected a predominantly Th1-type cytokine pattern with potent proinflammatory mediators. Factors reflecting a neutrophil and eosinophil immune response, due to IL-5, IL-8, GM-CSF, ECP, and elastase were shown. Nasal secretions of patients with allergic rhinitis showed highest concentrations of tryptase, IL-5, and ECP, reflecting a mast cell and eosinophil immune response. Nasal secretion levels of IL-4 did not show highest levels in allergic rhinitis but did in viral rhinitis. IL-4 also may play a role in limiting inflammatory processes by inhibiting the production of inflammatory cytokines.

Latex allergy, a special risk for patients of otorhinolaryngology and head and neck surgery?

A total of 206 patients of the otorhinolaryngology (ORL) department and 204 of the visceral surgery department of the Ludwig Maximilians University of Munich were preoperatively evaluated for latex-specific sensitization. A prick test, a questionnaire, and an enzyme-linked immunosorbent assay immunoprecipitation for IgE antibodies were performed. Latex is a widely spread allergen, and it does not only concern healthcare populations. Within the ORL surgery group, 43 (20.9%) patients were sensitized against latex allergen, and 2 of them were reported to manifest symptoms in consorting with latex. In the cohort of visceral surgery patients, we detected only 23 patients (11.3%) with sensitization against latex. Moreover, most patients were positively detected with the skin prick test (86.4%), whereas the enzyme-linked immunosorbent assay method was less sensitive (18.3%). Patients of the ORL department were considerably more frequently exposed to latex protein particles than patients of the visceral surgery department. This difference attributes to their significant difference in mean age: 44 years in the ORL patients group versus 58 years in the visceral patients cohort. Furthermore, we did not find any correlation to the number of past operations--although undergoing any surgical procedures is a well-known risk factor in other studies about latex sensitization in surgical patients.